HillaryCare II

About the Author

Senator Hillary Clinton (D., N.Y.) has unveiled a fairly
comprehensive health proposal that differs in key respects from her
1993-model. The new proposal covers a vast amount of territory:
health-insurance options for employers, employees and the
uninsured; new national rules for health insurance; new mandates on
employers as well as individuals; new financing arrangements, and
promised savings from a variety of measures, including targeted
cuts to private health plans in Medicare and government drug
pricing. Each one of these items could fill out a health policy
briefing book a foot thick, and at some point those three-ringed
volumes will appear.

It will be some time, though, before the details - and the
devils lurking within them - will emerge. While the outline is
certainly different from the earlier model, one detects similar
themes:

The financing relies on targeted Medicare reduction, employer
mandates and, of course, "revenue enhancements" that will come with
the promised end of the hated Bush tax cuts. It is unclear just how
many times Washington can expect to repeal the Bush tax cuts.

The plan would further the centralize Washington's control over
health-care delivery, including detailed federal regulation of the
health insurance markets,

Government is expected to trump competition when it comes to
eliminating economic inefficiencies. The plan seems to envision a
brainy bunch of experts gathering anew in the West Wing or HHS to
hammer out all the fine points of arcane insurance
regulations-including complex underwriting rules and the right
"stop-loss" ratios-that will produce health policy Nirvana: "the
provision of high quality care, not excessive profits and
marketing."

That old-fashioned central planning is objectionable on
philosophical and practical grounds. Moreover, Senator Clinton's
timing is wrong. Insurance markets differ radically in the states,
and innovative state leaders are experimenting with different
insurance rules for expanding both consumer choice and competition.
Washington did not know best in 1993, and it still doesn't.

Robert E.
Moffit is director of the Center for Health Policy Studies at
the Heritage
Foundation.